President Uhuru Kenyatta’s move to sign a bilateral agreement allowing Cuban specialist doctors to work in our county hospitals has drawn mixed reactions. Condemnation from a majority of Kenyan doctors with a few supporting the plan.
To see why the move was necessary, one needs only examine our current specialist doctors’ staffing situation — from training, recruitment to working.
From a citizen’s perspective, the verdict is that they are unreliable. In most hospitals specialist work only a few days a week and even then for a few hours. Quite the contrary from other countries where it is a full day job. A majority employed in the public sector spend more time in the private sector. This either due to a shortage or economic reasons.
The end result is that patients in the public sector are heavily shortchanged. It is the norm for them to be crammed into a one or two days a week schedule sometimes up to 60 or more for specialist clinics. Some argue this is the efficient way to work but the quality of care of such an arrangement is questionable.
Many counties in a bid to improve specialist’s numbers, offered training scholarships, paid or unpaid leave with reciprocal bonding times where such doctors were bound to work post-specialisation. The majority never remain in public service long enough, leaving for greener pastures in the private sector or urban areas after qualifying.
From an employer’s perspective, this is a double loss of both time and invested money. Perhaps these findings inform the government’s new move to look outside for this cadre of employees.
Kenya’s medical fraternity in the public sector has been blind to the patients’ and leaders’ views on our work ethics and professionalism. Our image has been greatly corroded over time. While this went on in the past due to our low numbers, changing global human resource trends and workforce economics must wake us up. For the first time, there are unemployed doctors in Kenya.
Where options are given, employers faced with biting financial times will choose to save costs. Here is where the Cuban idea makes sense. As “finished” products this is a saving on the government on training.
The practice of medicine is evolving, caught between harsh economic realities, technology shifts and legal obstacles. This Cuban experiment is just the first of many others. Ethiopian, Tanzanian, Zimbabwean doctors are also free to come, at least by free-market labour dictates.
The future of medicine is a fully open market economy, doctors will have to source for their own funds to study and then seek employment in very competitive markets.
Only those ready to realign with his reality will survive. We must adapt or perish.